HomeMy WebLinkAboutRental Application2OZS Rental Registration Application'o
TOWN OF \".{RMOUTH
Health f)epa rtmen t
I t46 ROITTE 2t, SOI-TH I ARMOIjTH
}IASSA('H T SETTS 0266{
Telephone (508) l9E-22J1. err- 1240
Far (508) 160-3117
E-mail: nrclaler,2 \'a rmouth.ma-us
Important Notice (PLEASE READ CAREFULLy):
fyou do not receive your rental certificate within 30 days ofsending in your application, please contact ourffice immediatelyl Please be aware that untilyou receive a rental ceitificate from the Heaith Department, yourroperty is being rented without a valid certificate, which may result in fines and other penalties.
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A rrrrefundable application fee of $gO per unit/rental is required
Rental Certificates expire on December 3L,t.2025.
To register online and pay via credit card, visit the Town ofyarmouth Hearth Departmentwebsite; https: / /wurv.var.mouth.nr?. ug / 1 Z7 / llca lth If you prefer to pay by check you may beginyour application online, After completing the in itial steps, ."ke yori ct ect pryabie to the To*n ofYarmouth, and be sure to incrude your BHR number lwnrcn witt be provided during the onrineapplication process) and your rental address. Make a note in the noies section that-yo*wiil besending a check. Mail the check to the address above.
If Nor registering onrine, prease make checks payable to: Town of yarmouth and maircompleted application (on reverse side) & payment to: Town of yarmouth Health Departmenr.
See Reverse Side )
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certificate.*review
tAn inspection may be required as part of this procest
Please note that occupancy limits are in place based on septic capacity and the number ofbedrooms. These measures are in place to protect our drinking watei and aquifers. AsYarmoutl prepares for a future transition to a town sewer rysiem, these steis are crucialfor preserving our water resources. previous occupancy detlrminahons may be sublect toadiustment based on the criteria mentioned above,
Please Print Clearly
Rental Property lnformation
All fields are required! lncomplete forms without a vo lid phone i, address, or e-moil address wilt not
Revised: 11 024
processed.
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Rental Property Address
eekly/Shon Term (less than 31 daysl _
Rental Period:
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Trash Removal by
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Rental of:
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Represenlative's E-mail Address
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Furthermore, I understand I must notify the Health Department in writing when I am no longer renting theproperty, or I may be subject to Rnes & fees.
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